HomeMy WebLinkAbout2968 ROYAL PALM DR - Building PermitsT
C)
T-
T
J)
4—
i L—L
I MAN I ®'SGT
0
49 X' on
saVf
J
Ast-
-MIDS
-b
CA
ft -T
SubjW to Ufl'i ivs
An n- us,
wred..nor-toBuikh n
OYES! I ln� n-
ES- I
a' e es
�cl
Lo
L
Am
-1-1?
-
4 --t
- - - - -------
If J
J
,
(714) 754-5273 • Fax (714) 754-4656 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 2968 ROYAL PALM DR
Suite:
Vicinity: DETACHED GARAGE
Parcel Number: 13920311
Applicant: REES, GARY
Address: 126 COMMERCIAL WY
COSTA MESA, CA
Owner: FRIZZELL, PAUL H TR
Address 2905 MONTECIELO RD
Zoning: R3 R3
Phone: 949-548-5569
Zip: 92627
Phone:
SANTA YNEZ, CA - Zip: 93460
Contractor: G L R ENTERPRISES INC/DBA CRANK BROTHERS ROOFING
Address: 126 COMMERCIAL WY
COSTA MESA, CA
Zip: 92627
Arch :
Address:
Phone: 949-548-5569
License: 828379
Eng
Address
Phone:
ISSUED BY:
Status: ISSUED
Applied: 03/01/2005
Issued: 03/01/2005
Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROCK ROOF & INSTALL NEW ROCK ROOF FOR EXISTING DETACHED GARAGES (10 SQ).
nspec Ion.
Total: $83.75
PLANNING & ZONING
SETBACKS --
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0,
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right_ " 0- 0 . '
PARKING Existing; 0 Required: 0 Proposed: 0'
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754.5626
t446-46 (aroo)
FEE SUMMARY
Plan Check:
$0.00 Calc Valuation: $2,350.00
Permit:
$83.25 u . Claim Valuation: $2,350.00
SMIP Res:
$0.50
SMIP Com:
$0.00
Other:
$0.00
I f
$0 00
nspec Ion.
Total: $83.75
PLANNING & ZONING
SETBACKS --
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0,
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right_ " 0- 0 . '
PARKING Existing; 0 Required: 0 Proposed: 0'
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754.5626
t446-46 (aroo)
ti
DECLARATIONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
I.heve
and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued.
k �My workers' It anon InsErance cam antl policy number are:
ear e I .:. (4 �`� c� n G� PVdicy NNumbee ; /77 _-2
00 t
—rrhis section need not oe completed if the permit is valued at one hundred dollars ($100) or iess.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these provision �J c
Applicant Signature:Date;
�2.-
"WATINING FAICUfiE TO SECURE RKERS' OOy6FNqA ION COVERAGE IS UNI-AWFUL AND SHALL SUBJECT AN F1.IPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLL4IRE($100,00)), I ADDITION Td THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37W OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions 0f Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
force and effect.Lt:ic-k �- g 1Class;d� r r� 4
Contractor's Signature: Date;_
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit t0 construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec.
7044, Business and Professions Cade: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Driver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 WIII the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
............................................................................................................................................................................................................................................................................................................................................................................................
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
.............................................................................................................................................................................................................................................................................................................................................................................I..............
3 Does or will theappplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
..................................................................................................................................................................................................-....................................................................................................................................................................................
4 If en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑tJo
........................................................... ................................................................................................................... ................................................................................. -................................................................. ............................... ..........................
5 Does or will the applicant or present or future building occupant require for the work which is the subject of thisa plication a ffrmil for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 8 Yes u No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
..............................................................................................................................-............................... -.................................. .................................................................................. -. ................... I ......................................................................
6 WIII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑ No
(If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
...................................................................................................................................................................... ___ ..................................................... .............................. .._..................................................
7 If a permit from the South Coast Air Quality Management Hl or other air pollution control district or agency is required for the work which is the subject of this
application, have e11 of the disclosures Prescribed by Californiaa Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8 (If yes", attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
r f n Date 9 S
A Lr AU
,?61zea'Applicant.. JL p--Oate,r�-
CODE ". INSPECTION TYPE 2AR INTMALS CODE11 INSPECTION TYPE 2AIE ffmal$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof_ 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
SIZE ,/ n
NO. OF BLDGB.EVES
• Jr r � v
COSTA MESA BUILDING -SAFETY DEPARTMENT
NOW ON LOT none
REQUIRED
P.O. BOX 317 COSTA MESA. CALIFORNIA
USE OF
(CENTER LINE
fOR 4MICANT TO F/ll /N COM]8115
APPL.ICATION;_F�OR� PERM�T
EXISTING BLDG.
TYPE OR PRINT
b 0 1 L.D IIN
FT.
FA_o4
BUILDING
ADDRESS 2968 Royal Pa Drive
COSTA MESA. CALIFORNIFOR
OFF/CE USE ONLY
�t�
OWNER Dike & Colegrove Inc.
RECEIPT NO. PERMIT NO
MAIL
ADDRESS 419 E. 17th Street(
RECEIV BY D TE RECEIVED DATE ISSUED
L' ,0��-1-5`J/G• y Sr
Costa Mesa TEL:BDDREINSS
CITY
R. SIDE
ARCHITECTo,LIC.ORENGINEER P•liddlebo No.COSTA
MESA, CALIFORNIA
ADDRESS Garden GroveFIRE
ZONE TYPE (/ GROUP
Inc.
Dike & Colegrove; nc• STATE 167293
APPROVED / D
CONTRACTOR LIC. NO.
BY DATE
ADDRESS 419 E. 17th St. Costa Mesa
ZONING
LEGAL I LOTZ6021-_V
I 2822
ZONE n ,1
NO: OF
USE OF NEW//
SIZE ,/ n
NO. OF BLDGB.EVES
OF LOT U /
NOW ON LOT none
REQUIRED
ALLOWED
USE OF
(CENTER LINE
ST.)
EXISTING BLDG.
FRONT
aa
�U
FT.
IN.
Y
SETBACK LINE FROM 'do
CENTER OF STREET Of REAR YARD
R. SIDE
IS'
PT�
IN.
SIDE YARD
LEFT 1
RIGHT 101
L. SIDE
D
FT.
., IN.
DESCRIPTION OF WORK
REAR
IN.
XII
I
NEW
ALTERATION
ADDITION
REPAIR
MOVING
I DEMOLISH
IDING
ROOMS
SIZE STORIES 2
3516
EXTERIOR WALLROOF'
(COVERING
COVERING Stuc
rock
USE OF BUILDING AND WORK
TO BE PERFORMED
-
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNOER VALUATION IS FOR THE
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COM
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BU ILDING. CONSTRUCTION.
VALUATION
SIGNATURE OF Dike & Colegrove, Inc. PERMIT FEES 49.00
PERMITTEE
�/// • / .n,/�/ _ S 29,l 1.4• a PLAN CHECK S 24-50
AUTHORIZE D -AGENT V 'NL
- TOTAL FEES 73•50
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 317 COSTA MESA. CALIFORNIA
fOR APPL/CANT A0 f/LL /N COMPLETELY
TYPE OR PRINT
ADD BUILDING Royal Palm Dr.
COSTA MESA, CALIFORNIA
MAIL
ADDRESS 419 E. 17th St.
■ ARCHITECT
ADDRESS 419 E. 1'
LEGAL LOT Qw-
USE OF
_ EXISTING BLDG.
SETBACK LINE FROM
FZ LIG.
uk NO.
ove
Inc. LIC. NO. 1672
th St.. Costa Mesa
atria
NO. OF BLDGS.
DESCRIPTION OF WORK
'BUILD
ING
IZE 730
EXTERIOR WALL
COVERING
USE OF BUILDING I
NO. OF
ROOMS STORIES
ROOF
COVERING
2K TO BE PERFORMED
Tar, mp.
a
'HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS n
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION.
SIGNATURE OF
PER
€c Colegr e, Inc.
AUTHORIZED AGENT
'- REGE &
(:Inlnq!n� nrnT
)LICATIONFOR- PERMIT
BUILDING --•S
FOR Off/CE USE ONLY
RECEIPT NO. I '.eE0�-=21
DATE
RECEjIVfE Y DATE RECEIVED I SSUEED
BUILDING
ADDRESS
COSTA MESA, CALIFORNIA
FIRE
ZONE TYPE /,' GROUP
APPROVED Apt/ 6
BY DATE
7
Y NING �.
ZONE NO.OF
PLANS /�I
USE OF
BUILDINGl-r'
APPROVED
BY DATE' /D/ -;` -Q
YARDS EVES .
REQUIRED ALLOWED
(CENTER LINE ST.1
FRONT B^'. IN.
R. SIDE - FT. IN.
L. SIDE FT. IN.
REAR FT. IN.
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
VALUATION
C
$ 1,821.00
PERMIT FEE $ 8.00
PLAN CHECK $ 4.00
TOTAL FEE $12.00